Search Results (95)

Background/Objectives: The diagnosis of pediatric dental conditions from panoramic radiographs is uniquely challenging due to the dynamic nature of the mixed dentition phase, which can lead to subjective and inconsistent interpretations. This study aims to develop and rigorously validate an advanced deep learning model to enhance diagnostic accuracy and efficiency in pediatric dentistry, providing an objective tool to support clinical decision-making. Methods: An initial comparative study of four state-of-the-art YOLO variants (YOLOv8, v9, v10, and v11) was conducted to identify the optimal architecture for detecting four common findings: Dental Caries, Deciduous Tooth, Root Canal Treatment, and Pulpotomy. A stringent two-tiered validation strategy was employed: a primary public dataset (n = 644 images) was used for training and model selection, while a completely independent external dataset (n = 150 images) was used for final testing. All annotations were validated by a dual-expert team comprising a board-certified pediatric dentist and an experienced oral and maxillofacial radiologist. Results: Based on its leading performance on the internal validation set, YOLOv11x was selected as the optimal model, achieving a mean Average Precision (mAP50) of 0.91. When evaluated on the independent external test set, the model demonstrated robust generalization, achieving an overall F1-Score of 0.81 and a mAP50 of 0.82. It yielded clinically valuable recall rates for therapeutic interventions (Root Canal Treatment: 88%; Pulpotomy: 86%) and other conditions (Deciduous Tooth: 84%; Dental Caries: 79%). Conclusions: Validated through a rigorous dual-dataset and dual-expert process, the YOLOv11x model demonstrates its potential as an accurate and reliable tool for automated detection in pediatric panoramic radiographs. This work suggests that such AI-driven systems can serve as valuable assistive tools for clinicians by supporting diagnostic workflows and contributing to the consistent detection of common dental findings in pediatric patients. Full article

Background: Periodontitis is a multifactorial disease leading to the loss of clinical attachment and alveolar bone. The diagnosis of periodontitis involves a clinical examination and radiographic evaluation, including panoramic images. Panoramic radiographs are cost-effective methods widely used in periodontitis classification. The remaining bone height (RBH) is a parameter used to assess the alveolar bone level. Large language models are widely utilized in the medical sciences. ChatGPT, the leading conversational model, has recently been extended to process visual data. The aim of this study was to assess the effectiveness of the ChatGPT models 4.5, o1, o3 and o4-mini-high in RBH measurement and tooth counts in relation to dental professionals’ evaluations. Methods: The analysis was based on 10 panoramic images, from which 252, 251, 246 and 271 approximal sites were qualified for the RBH measurement (using the models 4.5, o1, o3 and o4-mini-high, respectively). Three examiners were asked to independently evaluate the RBH in approximal sites, while the tooth count was achieved by consensus. Subsequently, the results were compared with the ChatGPT outputs. Results: ChatGPT 4.5, ChatGPT o3 and ChatGPT o4-mini-high achieved substantial agreement with clinicians in the assessment of tooth counts (κ = 0.65, κ = 0.66, κ = 0.69, respectively), while ChatGPT o1 achieved moderate agreement (κ = 0.52). In the context of RBH values, the ChatGPT models consistently exhibited a positive mean bias compared with the clinicians. ChatGPT 4.5 was reported to provide the lowest bias (+12 percentage points (pp) for the distal surfaces, width of the 95% CI for limits of agreement (LoAs) ~60 pp; +11 pp for the mesial surfaces, LoA width ~54 pp). Conclusions: ChatGPT 4.5 and ChatGPT o3 show potential in the assessment of tooth counts on a panoramic radiograph; however, their present level of accuracy is insufficient for clinical use. In the current stage of development, the ChatGPT models substantially overestimated the RBH values; therefore, they are not applicable for classifying periodontal disease. Full article

This study investigated the radiation attenuation characteristics of commonly used dental implant materials across an energy spectrum relevant to dental radiology. Two titanium implants were examined, with densities of 4.428 g/cm³ and 4.51 g/cm³, respectively. The first consisted of 90.39% titanium, 5.40% aluminum, and 4.21% vanadium, while the second comprised 58% titanium, 33% oxygen, 7% iron, 1% carbon, and 1% nitrogen. The third material was a zirconia implant (5Y form) composed of 94.75% zirconium dioxide, 5.00% yttrium oxide, and 0.25% aluminum oxide, exhibiting a higher density of 6.05 g/cm³. Monte Carlo simulations (MCNP6) and XCOM data were utilized to estimate photon source parameters, geometric configuration, and interactions with biological materials to calculate the half-value layer, mean free path, and tenth-value layer at varying photon energies. The results indicated that titanium alloys are well suited for low-energy imaging modalities such as CBCT and panoramic radiography due to their reduced artifact production. While zirconia implants demonstrated superior attenuation at higher energies (e.g., CT), their higher density may induce beam-hardening artifacts in low-energy systems. Future research should validate these simulation results through in vitro and clinical imaging and further explore the correlation between material-specific attenuation and CBCT image artifacts. Full article

Background/Objectives: Amelogenesis imperfecta (AI) represents a heterogeneous group of inherited disorders affecting the quality and quantity of dental enamel, making clinical diagnosis challenging. This study aimed to identify genetic variants in Slovenian patients with non-syndromic AI and to evaluate enamel morphology using radiographic parameters. Methods: Whole exome sequencing (WES) was performed on 24 AI patients and their families. Panoramic radiographs (OPTs) were analyzed using Fiji ImageJ to assess crown dimensions, enamel angle (EA), dentine angle (DA), and enamel–dentine mineralization ratio (EDMR) in lower second molar buds, compared to matched controls (n = 24). Two observers independently assessed measurements, and non-parametric tests compared EA, DA, and EDMR in patients with and without disease-causing variants (DCVs). Statistical models, including bootstrap-validated random forest and logistic regression, assessed variable influences. Results: DCVs were identified in ENAM (40% of families), AMELX (15%), and MMP20 (10%), including four novel variants. AI patients showed significant enamel deviations with high reproducibility, particularly in hypomineralized and hypoplastic regions. DA and EDMR showed significant correlations with DCVs (p < 0.01). A bootstrap-validated random forest model yielded a 90% (84.0–98.0%) AUC-estimated predictive power. Conclusions: These findings highlight a novel and reproducible radiographic approach for detecting developmental enamel defects in AI and support its diagnostic potential. Full article

To address the widespread challenges of significant multi-category dental morphological variations and interference from overlapping anatomical structures in panoramic dental X-ray images, this paper proposes a dual-stream dental segmentation model based on Transformer heterogeneous feature complementarity. Firstly, we construct a parallel architecture comprising a Transformer semantic parsing branch and a Convolutional Neural Network (CNN) detail capturing pathway, achieving collaborative optimization of global context modeling and local feature extraction. Furthermore, a Pooling-Cooperative Convolutional Module was designed, which enhances the model’s capability in detail extraction and boundary localization through weighted centroid features of dental structures and a latent edge extraction module. Finally, a Semantic Transformation Module and Interactive Fusion Module are constructed. The Semantic Transformation Module converts geometric detail features extracted from the CNN branch into high-order semantic representations compatible with Transformer sequential processing paradigms, while the Interactive Fusion Module applies attention mechanisms to progressively fuse dual-stream features, thereby enhancing the model’s capability in holistic dental feature extraction. Experimental results demonstrate that the proposed method achieves an IoU of 91.49% and a Dice coefficient of 94.54%, outperforming current segmentation methods across multiple evaluation metrics. Full article

Background/Objectives: In dental medicine, the integration of various types of X-ray images, such as periapical (PA), bitewing (BW), and panoramic (PANO) radiographs, is crucial for comprehensive oral health assessment. These complementary imaging modalities provide diverse diagnostic perspectives and support the early detection of oral diseases, thereby enhancing treatment outcomes. However, there is currently no existing system that integrates multiple types of dental X-rays for both adults and children to perform tooth localization and numbering. Methods: Therefore, this study aimed to propose a system based on YOLOv8 that integrates multiple dental X-ray images and automatically detects and numbers both permanent and deciduous teeth. Through image preprocessing, various types of dental X-ray images were standardized and enhanced to improve the recognition accuracy of individual teeth. Results: With the implementation of a novel image preprocessing method, the system achieved a detection precision of 98.16% for permanent and deciduous teeth, representing a 3% improvement over models without image enhancement. In addition, the system attained an average tooth numbering accuracy of 98.5% for permanent teeth and 96.3% for deciduous teeth, surpassing existing methods by 5.6%. Conclusions: These results might highlight the innovation of the proposed image processing method and show its practical value in assisting clinicians with accurate diagnosis of tooth loss and the identification of missing teeth, ultimately contributing to improved diagnosis and treatment in dental care. Full article

This study aimed to demonstrate the Convolutional Neural Network (CNN) algorithm’s efficiency in detecting alveolar bone loss using panoramic radiographs. The comparison was evaluated among 1874 pictures retrieved from an institution, from which the training set included 953 showing bone loss and 921 normal cases. A confusion matrix was performed for statistical analysis. The CNN method correctly identified 92 out of 100 bone loss cases and 89 out of 100 healthy cases. The model showed a sensitivity of 0.8327, a specificity of 0.8683, a precision of 0.8918, an accuracy of 0.8927, and an F1 score of 0.8615 in detecting bone loss. This study concluded that a faster CNN model may be used as an adjuvant technique to diagnose periodontal disease and alveolar bone loss using dental panoramic radiography images, thereby minimizing diagnostic effort, and saving assessment time. However, the execution of precisely detecting periodontal cases by fully automated AI models using panoramic radiographs appears imminent and needs clinical periodontal evaluation for definitive diagnosis. The suitability of this approach is supported by the sensitivity, specificity, accuracy, and F-measure, which showed satisfactory performance for classifying cases. Based on population and periodontal disease burden standpoint, the use of AI in diagnosing periodontal diseases may serve as an excellent surveillance method to classify alveolar bone loss. Monitoring a periodontal patient after treatment needs a wide area to cover by AI-based diagnostic modality. With AI as the future of dentistry, performance-based clinical usage of CNN models demands confirmed practical application by dentists. Full article

Background: Dental radiographs play a crucial role in diagnosis and treatment planning. With the rise in digital imaging, there is growing interest in leveraging artificial intelligence (AI) to support clinical decision-making. AI technologies can enhance diagnostic accuracy by automating tasks like identifying and locating dental structures. The aim of the current study was to assess and validate the accuracy of an AI-powered application in the detection and numbering of primary teeth on panoramic radiographs. Methods: This study examined 598 archived panoramic radiographs of subjects aged 4–14 years old. Images with poor diagnostic quality were excluded. Three experienced clinicians independently assessed each image to establish the ground truth for primary teeth identification. The same radiographs were then evaluated using EM2AI, an AI-based diagnostic software for the automatic detection and numbering of primary teeth. The AI’s performance was assessed by comparing its output to the ground truth using sensitivity, specificity, predictive values, accuracy, and the Kappa coefficient. Results: EM2AI demonstrated high overall performance in detecting and numbering primary teeth in mixed dentition, with an accuracy of 0.98, a sensitivity of 0.97, a specificity of 0.99, and a Kappa coefficient of 0.96. Detection accuracy for individual teeth ranged from 0.96 to 0.99. The highest sensitivity (0.99) was observed in detecting upper right canines and primary molars, while the lowest sensitivity (0.79–0.85) occurred in detecting lower incisors and the upper left first molar. Conclusions: The AI module demonstrated high accuracy in the automatic detection of primary teeth presence and numbering in panoramic images, with performance metrics exceeding 90%. With further validation, such systems could support automated dental charting, improve electronic dental records, and aid clinical decision-making. Full article

Background/Objectives: Panoramic radiography (PANO) is widely utilized for routine dental examinations, as a single PANO image captures most anatomical structures and clinical findings, enabling an initial assessment of overall dental health. Dentists rely on PANO images to enhance clinical diagnosis and inform treatment planning. With the advancement of artificial intelligence (AI), the integration of clinical data and AI-driven analysis presents significant potential for supporting medical applications. Methods: The proposed method focuses on the segmentation and localization of impacted third molars in PANO images, incorporating Sobel edge detection and enhancement methods to improve feature extraction. A convolutional neural network (CNN) was subsequently trained to develop an automated impacted tooth detection system. Results: Experimental results demonstrated that the trained CNN achieved an accuracy of 84.48% without image preprocessing and enhancement. Following the application of the proposed preprocessing and enhancement methods, the detection accuracy improved significantly to 98.66%. This substantial increase confirmed the effectiveness of the image preprocessing and enhancement strategies proposed in this study. Compared to existing methods, which achieve approximately 90% accuracy, the proposed approach represents a notable improvement. Furthermore, the entire process, from inputting a raw PANO image to completing the detection, takes only 4.4 s. Conclusions: This system serves as a clinical decision support system for dentists and medical professionals, allowing them to focus more effectively on patient care and treatment planning. Full article

Background: Traumatic injuries to the alveolar process and primary teeth in early childhood can have long-term consequences on the development of permanent dentition and eruption pathways. Objective: This case report aims to illustrate the impact of early orofacial trauma on the eruption and development of permanent maxillary incisors and to emphasize the importance of timely interdisciplinary management. Case Presentation: An 8-year-old female patient presented to a pediatric dentistry clinic with delayed eruption of the maxillary anterior permanent teeth. In contrast, her monozygotic twin sister exhibited complete eruption of all permanent anterior teeth, raising parental concern regarding a possible pathological delay. Her medical history revealed orofacial trauma at the age of two, resulting in an alveolar process fracture, avulsion of the primary maxillary left central incisor (tooth 61), and luxation of the primary maxillary right central incisor (tooth 51). A clinical examination demonstrated sufficient arch space without signs of eruption and enamel defects on tooth 52. Radiographic evaluations, including panoramic imaging and cone beam computed tomography (CBCT), confirmed the presence of impacted permanent teeth with structural anomalies suggestive of trauma-related developmental disturbances. Results: The patient underwent a multidisciplinary treatment over a three-year period involving pediatric dentistry, oral surgery, and orthodontics. Management included surgical exposure of the impacted teeth followed by orthodontic traction to guide the eruption and treatment of enamel hypoplasia. Conclusions: This case highlights the long-term consequences of early traumatic dental injuries on permanent dentition development. It underscores the necessity of early diagnosis and a coordinated interdisciplinary approach to optimize outcomes and enhance the long-term oral health and quality of life of affected individuals. Full article

Diagnostic imaging is fundamental in dentistry for disease detection, treatment planning, and outcome assessment. Traditional radiographic methods, such as periapical and panoramic radiographs, along with cone beam computed tomography (CBCT), utilize ionizing radiation and primarily focus on visualizing bony structures. Magnetic resonance imaging (MRI) is emerging as a non-ionizing alternative that offers superior soft tissue contrast. However, standard MRI sequences face challenges visualizing mineralized tissues due to their short transverse relaxation times (T2), which results in rapid signal decay. Recent advancements exploring short T2 sequences, including Ultrashort Echo Time (UTE), Zero Echo Time (ZTE), and Sweep Imaging with Fourier Transformation (SWIFT), allow direct visualization of dental hard tissues. UTE captures signals from short T2 tissues using rapid pulse sequences, while ZTE employs encoding gradients before radiofrequency pulses to reduce signal loss. SWIFT enables near-simultaneous excitation and acquisition, improving ultrashort T2 detection. Additionally, customized intraoral and extraoral surface coils enhance the image resolution and signal-to-noise ratio (SNR), increasing MRI’s relevance in dentistry. Research highlights the potential of these short T2 sequences for early caries detection, pulp vitality assessment, and diagnosing jaw osseous pathology. While high-field MRI (3 T–7 T) improves resolution and increases susceptibility artifacts, low-field systems with specialized coils and short sequences offer promising alternatives. Despite obstacles such as cost and hardware constraints, ongoing studies refine protocols to enhance clinical applicability. Incorporating MRI in dentistry promises a safer, more comprehensive imaging methodology, potentially transforming diagnostics. This review emphasizes three types of short T2 sequences that have potential applications in the maxillofacial region. Full article

Artificial intelligence (AI) is increasingly used in healthcare, including dental and periodontal diagnostics, due to its ability to analyze complex datasets with speed and precision. Backgrounds and Objectives: This study aimed to evaluate the reliability of AI-assisted dental–periodontal diagnoses compared to diagnoses made by senior specialists, specialists, and general dentists. Material and Methods: A comparative study was conducted involving 60 practitioners divided into three groups—general dentists, specialists, and senior specialists—along with an AI diagnostic system (Planmeca Romexis 6.4.7.software). Participants evaluated six high-quality panoramic radiographic images representing various dental and periodontal conditions. Diagnoses were compared against a reference “gold standard” validated by a dental imaging expert and senior clinician. A statistical analysis was performed using SPSS 26.0, applying chi-square tests, ANOVA, and Bonferroni correction to ensure robust results. Results: AI’s consistency in identifying subtle conditions was comparable to that of senior specialists, while general dentists showed greater variability in their evaluations. The key findings revealed that AI and senior specialists consistently demonstrated the highest performance in detecting attachment loss and alveolar bone loss, with AI achieving a mean score of 6.12 in identifying teeth with attachment loss, compared to 5.43 for senior specialists, 4.58 for specialists, and 3.65 for general dentists. The ANOVA highlighted statistically significant differences between groups, particularly in the detection of attachment loss on the maxillary arch (F = 3.820, p = 0.014). Additionally, AI showed high consistency in detecting alveolar bone loss, with comparable performance to senior specialists. Conclusions: AI systems exhibit significant potential as reliable tools for dental and periodontal assessment, complementing the expertise of human practitioners. However, further validation in clinical settings is necessary to address limitations such as algorithmic bias and atypical cases. AI integration in dentistry can enhance diagnostic precision and patient outcomes while reducing variability in clinical assessments. Full article

Background/Objectives: Osteogenesis Imperfecta (OI) is a congenital disorder, in which the production of collagen, mainly type I, is altered, leading to a decrease in bone mineral density, increasing the risk of fracture with minimal trauma. Several studies have analyzed bone mineral density in osteoporotic patients based on linear measurements such as radiomorphometric indices measured with panoramic radiographs, although few studies have investigated bone trabeculation in children diagnosed with OI. Therefore, the aim of the present investigation was to analyze the dental panoramic indices in panoramic radiographs in the cortical and trabeculated bone of children with OI. Methods: Thus, 66 pediatric patients diagnosed with OI under antiresorptive treatment were compared with a sample of controls matched for sex and age. Using Image J software (version: 1.54d), three radiomorphometric indices were analyzed in orthopantomographies of the study and control groups, evaluating the influence of disease severity as well as the type of antiresorptive treatment administered. Results: Patients with OI had a higher presence of type C2 and C3 MCI (mandibular cortical index) than their matched controls (p < 0.05), although no differences were found for the visual estimation of cortical width (SVE) and mandibular cortical width (MCW). Treatment with zoledronic acid was associated with a higher number of cases of type C1 MCI, in terms of sample description, while patients treated with a combination of pamidronate and zoledronic acid had a higher rate of type C1 and C2 MCI, with no statistical differences. Conclusions: In the overall sample, most patients showed a thin SVE index (59.1%), a C2 or C1 type MCI (46.2% and 42.4%) and an MCW of 2.9 mm. Differences in bone mineral density were also observed throughout growth and the different antiresorptive treatments. Zoledronic acid has been associated with a higher percentage of C1 and C3 ICM, and pamidronate alone or in combination is associated with a C1 and C2 MCI index. Full article

This paper presents the development of a generative adversarial network (GAN) for the generation of synthetic dental panoramic radiographs. While this is an exploratory study, the ultimate aim is to address the scarcity of data in dental research and education. A deep convolutional GAN (DCGAN) with the Wasserstein loss and a gradient penalty (WGAN-GP) was trained on a dataset of 2322 radiographs of varying quality. The focus of this study was on the dentoalveolar part of the radiographs; other structures were cropped out. Significant data cleaning and preprocessing were conducted to standardize the input formats while maintaining anatomical variability. Four candidate models were identified by varying the critic iterations, number of features and the use of denoising prior to training. To assess the quality of the generated images, a clinical expert evaluated a set of generated synthetic radiographs using a ranking system based on visibility and realism, with scores ranging from 1 (very poor) to 5 (excellent). It was found that most generated radiographs showed moderate depictions of dentoalveolar anatomical structures, although they were considerably impaired by artifacts. The mean evaluation scores showed a trade-off between the model trained on non-denoised data, which showed the highest subjective quality for finer structures, such as the mandibular canal and trabecular bone, and one of the models trained on denoised data, which offered better overall image quality, especially in terms of clarity and sharpness and overall realism. These outcomes serve as a foundation for further research into GAN architectures for dental imaging applications. Full article

Odontogenic sinusitis is a type of sinusitis caused by apical lesions of teeth near the maxillary sinus floor. Its clinical symptoms are highly like other types of sinusitis, often leading to misdiagnosis as general sinusitis by dentists in the early stages. This misdiagnosis delays treatment and may be accompanied by toothache. Therefore, using artificial intelligence to assist dentists in accurately diagnosing odontogenic sinusitis is crucial. This study introduces an innovative odontogenic sinusitis image processing technique, which is fused with common contrast limited adaptive histogram equalization, Min-Max normalization, and the RGB mapping method. Moreover, this study combined various deep learning models to enhance diagnostic accuracy. The YOLO 11n model was used to detect odontogenic sinusitis single tooth position in dental panoramic radiographs and achieved an accuracy of 98.2%. The YOLOv8n-cls model diagnosed odontogenic sinusitis with a final classification accuracy of 96.1%, achieving a 16.9% improvement over non-enhanced methods and outperforming recent studies by at least 4%. Additionally, in clinical applications, the classification accuracy for non-odontogenic sinusitis was 95.8%, while for odontogenic sinusitis it was 97.6%. The detection method developed in this study effectively reduces the radiation dose patients receive during CT imaging and serves as an auxiliary system, providing dentists with reliable support for the precise diagnosis of odontogenic sinusitis. Full article